MD

Back to Basics: New Trends in Medicine

No-frills space gives docs luxury of time

From the September ACP Observer, copyright © 2007 by the American College of Physicians.

By Ryan DuBosar

Patients walking into general internist Soma Mandal, MD’s, Manhattan office in New York City see her immediately—she’s the only person in the practice. She relies on patients to complete their histories before their visit and she verifies insurance in advance. With all the paperwork addressed, she can then devote anywhere from 20 minutes for a routine visit to 40 minutes for a new patient—all of it clinical time.

The luxury of such long visits is a welcome shift from her previous work at a hurried Lower East Side community health clinic. Treating the underserved was rewarding, but the overhead of a large facility demanded she fit patients into 15-minute slots, leaving only five to seven minutes for clinical work. She moved to a large Brooklyn medical practice, but 40- to 50-hour weeks were similarly frenzied. So she began plotting how to strike out on her own.

“I realized that the only way I could take control would be to start my own practice,” she said. Unable to get a bank loan, she covered the $20,000 in startup costs herself and opened her scaled-down practice in September 2006.

By moving to a tiny office with no staff and minimal equipment, she lowered her overhead costs to an income-to-overhead ratio of 8:1. This allows her to restrict her patient load per week to about 20 patients in four half-day sessions, even while continuing to practice in New York’s Gramercy Park neighborhood.


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Shreya Mandal's picture

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Black Women Needed for Breast Cancer Study

Black Women Needed for Breast Cancer Study

Washington Afro American, News Feature, Alafaka Opuiyo, Posted: Aug 16, 2007

Editor's note: Lack of trust in the American medical system still negatively affects the number of African-American women participants in medical studies.

Millions of women are diagnosed with breast cancer annually, especially black women. The National Institute of Environmental Health Sciences (NIEHS) is conducting the country's largest study that looks at genetics and environment to assess the risk of breast cancer called the Sister Study. Women who have sisters with breast cancer are used for the study.

Since the study started in October 2004, it has recruited over 38,000 women, but only 5 percent of them are black women. In Washington, D.C., only 35 black women have signed up to participate in the study.

"Recruitment of African-American women has been slow but steady," Carrissa Dixon, Sister Study's recruitment coordinator said. "I think fear and a lack of trust [prevent] black women from participating."

Dixon is responsible for disseminating information about the study to black women. She said that most breast cancer research is conducted with white women, and that it is important for black women to participate in these studies so they are represented in the findings.

Churches, black hair salons and black hair shows are some of the venues Dixon has used to sign women up for the study.


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Shreya Mandal's picture

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In the Post article, Maryscott says at least one thing that is both true and wise, which is that her rage and her blogging are both "born of powerlessness." The problem is that Lord Acton's maxim is equally true in reverse: If power corrupts, so does powerlessness. It can lead to fatalism, apathy and irresponsibility %u2013 or to paranoia, rage and a willingness to believe evey loopy conspiracy theory that comes down the pike.

The difference, I think, between left and right is that the right has no rational justification to feel any of these things, and yet many, if not most, conservatives continue to wallow in the mindset of a besieged minority.

Liberals, much less radical progressives, really are a besieged minority in this country. So why is it suddenly considered front-page news that they're acting like one?

The answer, of course, is that if the Maryscotts of Left Blogistan are evidence of the corruption of powerlessness, the Washington Post is proof positive of Lord Acton's original argument. Given everything that's going on around us, it's hard to imagine that anyone would believe the former is more of a threat to the republic than the latter. But I guess that's what the corruption of power is all about.


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